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As these structures cannot be restored once damaged, functional restoration of AC defects remains a major challenge. We report that the use of a converged bioprinted, osteochondral implant, based on a gelatin methacryloyl cartilage phase, reinforced with precisely patterned melt electrowritten polycaprolactone micrometer\u2010scale fibers in a zonal fashion, inspired by native collagen architecture, can provide long\u2010term mechanically stable neo\u2010tissue in an orthotopic large animal model. The design of this novel implant was achieved via state\u2010of\u2010the\u2010art converging of extrusion\u2010based ceramic printing, melt electrowriting, and extrusion\u2010based bioprinting. Interestingly, the cell\u2010free implants, used as a control in this study, showed abundant cell ingrowth and similar favorable results as the cell\u2010containing implants. Our findings underscore the hypothesis that mechanical stability is more determining for the successful survival of the implant than the presence of cells and pre\u2010cultured extracellular matrix. This observation is of great translational importance and highlights the aptness of advanced 3D (bio)fabrication technologies for functional tissue restoration in the harsh articular joint mechanical environment.<\/jats:p>","DOI":"10.1002\/btm2.10614","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T05:41:20Z","timestamp":1697694080000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Orthotopic equine study confirms the pivotal importance of structural reinforcement over the pre\u2010culture of cartilage implants"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8685-8379","authenticated-orcid":false,"given":"Myl\u00e8ne","family":"de Ruijter","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, RMCU Utrecht, UMC Utrecht University of Utrecht  Utrecht The Netherlands"},{"name":"Department of Clinical Sciences, Faculty of Veterinary Medicine Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7723-2657","authenticated-orcid":false,"given":"Paweena","family":"Diloksumpan","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Veterinary Medicine Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Dokter","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, RMCU Utrecht, UMC Utrecht University of Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3622-8571","authenticated-orcid":false,"given":"Harold","family":"Brommer","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Veterinary Medicine Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ineke H.","family":"Smit","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Faculty of Veterinary Medicine Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3795-3804","authenticated-orcid":false,"given":"Riccardo","family":"Levato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, RMCU Utrecht, UMC Utrecht University of Utrecht  Utrecht The Netherlands"},{"name":"Department of Clinical Sciences, Faculty of Veterinary Medicine Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-1817","authenticated-orcid":false,"given":"P. 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